RELATIONSHIP OF REGIONAL WALL-MOTION ABNORMALITIES DETECTED BY BIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY AND ELECTROCARDIOGRAPHIC CHANGES INPATIENTS UNDERGOING CORONARY-ARTERY BYPASS GRAFT-SURGERY

Background: It has been demonstrated that new regional wall motion abn ormalities (RWMAs) are infrequently associated with electrocardiograph ic (EGG) ischemic changes during coronary artery bypass graft (CABG) s urgery. The evaluation of apical or basal areas by biplane transesopha geal echocardiography (TEE) may clarify the relationship between RWMA and ECG changes. Methods: Biplane TEE and ECG (leads II and V-5) were continuously monitored in a total of 98 patients undergoing CABG surge ry to determine the incidence and characteristics of RWMAs and to rela te these findings to ECG changes. Results: Twenty-four new RWMAs were detected in 21 (21%) patients. Incidences of new RWMAs in each view we re found to be as follows: 12 (50%) in short-axis view (SAV); 5 (21%) in long-axis view (LAV); and 7 (29%) in both views. Ten of the 24 new RWMA episodes (42%) corresponded to ECG ischemic changes. These new EC G changes were significantly more common when the new RWMAs appeared o n both views (86%) as compared with the LAV alone (0%) (p < 0.01) or w ith SAV alone (33%). Moreover, in patients with a greater number of ab normal segments (>3), new RWMAs were significantly (p < 0.05) associat ed with ECG changes. Conclusion: Biplane TEE provides additional infor mation about spatial distribution of new RWMAs. This study was the fir st to demonstrate that a clear relationship between TEE and ECG ischem ia exists. When these new RWMAs exhibited a large spatial distribution , the frequency of ECG ischemic changes increased. Copyright (C) 1996 by WB. Saunders Company